DOTS：結核防治之最佳策略

DOTS: The Most Effective Strategy For Tuberculosis Control

江振源(Chen-Yuan Chiang)

《胸腔醫學》 15卷4期 (2000/12) Pp. 172-177

摘要

DOTS是世界衛生組織推薦的結核防治策略。DOTS-- Directly Observed Treatment, Short Course，不只是短程直接監督治療，不只是看著病人服藥，DOTS是一個包括五大要項的配套策略：（1）結核防治之政治承諾，（2）痰塗片檢驗、因症就診之被動式病人發現法，（3）標準化之短程治療，且至少前兩個月之直接監督療法，（4）充足之藥物供應，（5）標準化之登記與通報系統。DOTS源自於不當的治療比不治療更糟的觀念變革，以及國際抗癆暨肺病聯盟之國家結核防治典範計劃（Model National Tuberculosis Programme）之經驗累積。世界衛生組織於1993年史無前例地宣佈單一疾病--結核病之全球危機。至1998年底，採行DOTS的國家已增加到119個，DOTS的涵蓋面已達全球43%的人口。台灣每年約有一萬三千五百個新病人發病，結核疫情每十萬人口61.3，而且原發性抗藥率逐步攀升，我們需要DOTS策略。

關鍵字

直接監督療法 ； 結核病

並列摘要

DOTS (Directly Observed Treatment, Short-course) is the brand name of the WHO-endorsed tuberculosis control strategy. DOTS strategy has five components: (1) government commitment to sustained TB control, (2) case detection by sputum smear microscopy among symptomatic patients self-reporting to health services, (3) standardized short-course chemotherapy with directly observed treatment (DOT) for at least the initial two months, (4) a regular, uninterrupted supply of all essential anti-TB drugs, (5) a standardized recording and reporting system. The DOTS strategy was modeled after the program developed by Dr. Karel Styblo of the International Union Against Tuberculosis and Lung Disease. The issue of tuberculosis control has been ignored for more than 20 years by World Health Organization (WHO) when considering health priorities in low-income countries. The announcement by the WHO in 1993 that tuberculosis has become a global emergency was unprecedented. By the end of 1998, 119 countries had adopted the DOTS strategy for TB control; 43% of the global population had access to DOTS. There were 13,496 newly diagnosed TB cases with the incidence rate of 61.3 per 100,000 population in 1999 in Taiwan, and the antituberculosis drug resistance rate is increasing. We should implement DOTS strategy for tuberculosis control in Taiwan.

並列關鍵字

DOTS ； Directly Observed Treatment ； tuberculosis